THE BURNS ANXIETY INVENTORY 
                  Name:                                                        Date:  
                  
                                                                                                                 
                                                                                                          t     y
                                                                                                   l      a     l
                                                                                                                e
                                                                                                   Al     h     t
                  Place a check mark in the box to the right of each category to indicate how      t      w     ra     
                                                                                                   a            e     t
                                                                                                   t      me          Lo
                  much this type of feeling has bothered you in the past several days.             o      o
                                                                                                   N      S     Mod   A 
                                                                                                   =                   
                                                                                                           =     =     =
                                                                                                   0      1     2     3
                  Category I: Anxious Feelings 
                  1    Anxiety, nervousness, worry or fear                                                           
                  2    Feeling that things around you are strange or unreal                                          
                  3    Feeling detached from all or part of your body                                                
                  4    Sudden unexpected panic spells                                                                
                  5    Apprehension or a sense of impending doom                                                     
                  6    Feeling tense, stressed, “uptight” or on edge                                                 
                  Category II: Anxious Thoughts 
                  7    Difficulty concentrating                                                                      
                  8    Racing thoughts                                                                               
                  9    Frightening thoughts                                                                          
                  10  Feeling that you’re on the verge of losing control                                             
                  11  Fears of cracking up or going crazy                                                            
                  12  Fears of fainting or passing out                                                               
                  13  Fears of physical illnesses or heart attacks or dying                                          
                  14  Concerns about looking foolish or inadequate                                                   
                  15  Fears of being alone, isolated, or abandoned                                                   
                  16  Fears of criticism or disapproval                                                              
                  17  Fears that something terrible is about to happen                                               
                  Category III: Physical Symptoms 
                  18  Skipping, racing or pounding of the heart (palpitations)                                       
                  19  Pain, pressure, or tightness in chest                                                          
                  20  Tingling or numbness of toes and fingers                                                       
                  21  Butterflies or discomfort in the stomach                                                       
                  22  Constipation or diarrhea                                                                       
                  23  Restlessness or jumpiness                                                                      
                  24  Tight, tense muscles                                                                           
                  25  Sweating not brought on by heat                                                                
                  26  A lump in the throat                                                                           
                  27  Trembling or shaking                                                                           
                  28  Rubbery or “jelly” legs                                                                        
                  29  Feeling dizzy, lightheaded or off balance                                                      
                  30  Choking or smothering sensations or difficulty breathing                                       
                  31  Headaches or pains in the neck or back                                                         
                  32  Hot flashes or cold chills                                                                     
                  33  Feeling tired, weak, or easily exhausted                                                       
                                                           Total score for items 1 through 33:                        0
               
                 TOTAL SCORE               DEGREE OF ANXIETY 
                      0-4        Minimal or no anxiety 
                     5-10        Borderline anxiety 
                     11-20       Mild Anxiety 
                     21-30       Moderate Anxiety 
                     31-50       Severe Anxiety 
                     51-99       Extreme Anxiety or Panic 
               
              Thank you for completing the Burn’s Anxiety Inventory.  If you have concerns about your 
              results and would like to speak with a GTCC counselor, please email: 
              counselingcenter@gtcc.edu or call (336) 334-4822 Ext. 50038 to request an appointment.